| NPI | 1114995552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME83234) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME83234) |
| 207L00000X Anesthesiology (Licence: FL ME83234) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2015-09-18 |